Cardiotoxic effects of antimony dimercaptosuccinate in schistosomiasis. With special reference to coexistent hepatic dysfunction

Two-hundred and one electrocardiograms recorded in 38 patients with schistosomiasis who received 42 courses of therapy with antimony dimercaptosuccinate are reviewed; special attention was directed toward the relationship of hepatic dysfunction to cardiac toxicity. Significant electrocardiographic changes, when they occurred, involved the T waves. The electrocardiographic findings were similar to those observed with other antimony compounds, but were less severe in magnitude and incidence. Twenty-six patients showed little or no change in electrocardiogram, 9 had T wave lowering and inversions in more than one lead, and 3 had severe T wave changes in multiple leads with cove-plane T waves. One patient in this last group developed ventricular premature contractions. These electrocardiographic changes did not appear to be dose-dependent. Elevation of SGOT could not be correlated with the T wave changes. Women seemed to be more severely affected than men. The presence of hepatic schistosome granuloma had no effect on the degree of electrocardiographic changes, hut cardiotoxicity from the drug may be increased with liver damage.